2024 Trekking Camp Enrolment

General Enrolment Information
Camper's Name*

First NameLast Name
Gender*

MaleFemale
School year at time of camp*
Birth Date*

DayMonthYear
Contact Information
Caregiver's Email*
example@example.com
Caregiver's Phone Number*
Camper's Email (if applicable)
example@example.com
Camper's Phone Number (if applicable)
Camper's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Photo of Camper for Identification at Camp

This is not necessary, but can be helpful for our camp staff to indentify a camper. ESPECIALLY if medication is required.
Cancelof
Caregiver and Emergency Contacts
Caregiver 1 Information

This is the person the camper usually resides with.
Caregiver 1's Name*

First NameLast Name
Relationship to Camper*
Caregiver 1's Phone Number*
Second Phone Number (if applicable)
Caregiver 2 Information

This is usually the spouse or partner of caregiver 1 OR another person the camper may reside with at times.
Caregiver 2's Name*

First NameLast Name
Relationship to Camper*
Caregiver 2's Phone Number*
Second Phone Number (if applicable)
Emergency Contact Information

It is important we have a DIFFERENT third person who will be contacted only if we are unsuccessful in our attempts to contact the parents/caregivers listed above.
Emergency Contact's Name*

First NameLast Name
Relationship*
Emergency Contact's Primary Phone Number*
Secondary Phone Number (if applicable)

Child's Swimming Ability

Some of our camps may include swimming and/or water based activities. It is important our staff know the level of swimming ability to safely plan these activities.
What is the camper's swimming ability, to the best of your knowledge?*

Unable (unable to swim at all)Beginner (basic strokes, could swim to the end of an indoor swimming pool)Good (confident swimmer, could swim at least 10 meters in an indoor swimming pool)Excellent (can confidently swim 50 meters with clothing on)UnknownPermission Denied (I do not wish for my child to participate in swimming activities)
Transport
How will the camper be arriving at camp?

Private transportBus Company (Camper needs CYC to pick up/drop off in Waihola)
Name of Bus Company
Location of Pick Up
Arrival Time

MonthDayYear
Date
Hour MinutesAM/PM Option
Name of Bus Company
Location of Drop Off
Departure Time

MonthDayYear
Date
Hour MinutesAM/PM Option
People Authorised to Collect Camper*
It is important we know who is and is NOT allowed to collect your child at the end of camp. This person will need to sign your child out.

Behavioural Information
Notification of Behavioural Issues
- It is very important that our camp staff know of any behavioural issues that could arise during camp.
- We use this information to manage camper behaviour and suitable leadership. Unfortunately, if we don't know about existing issues and they arise, we may unknowingly send a camper home rather than implement known solutions.
Does the camper have any behavioural issues?

NoYes
Examples of a Behavioural Issues List:

Bullying:
- John can sometimes bully other children.
- This relates to him being bullied as a younger child by older siblings.
- A stern word given at the start of camp by the leaders or camp director explaining the consequences of bullying at camp, would help John know it is not tolerated.
- A phone call to parents at the end of day 1 will allow us to ensure there is no problem.
Inattention:
- John can sometimes not pay attention during group instructions.
- Having a leader buddied up with John to ensure he understands any instructions given will certainly help.
Please list behavioural issues that may arise:
Other Enrolment Information
Other Enrolment Information/Comments - Note: Cabin requests can not be changed within 7 days of camp beginning
Please use this field to note any other information we should know regarding the enrolment.